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In examining the causative factors in Barbara's illness, I feel that the relationship with her mother was of primary importance. In her
case, and this is probably typical, there existed an unconscious rapport between Barbara and her mother. Barbara reacted to her mother's unconscious hostility, characterized by ambivalence and, at times, open sadistic attitudes, with an increase of sadism and narcissism, accompanied by an unconscious obedience, almost as though she had to do what she felt her mother unconsciously wanted her to do. "All right, you want me to be sick; I'll be sick but you'll be sorry," Barbara once actually said to her mother preceding the onset of the leg ulcer. One day when her mother admonished her to be careful and not to fall on crossing the slippery street, Barbara's reaction was, "Please don't tell me this or I'll have to fall." Her mother's mention of the possibility of falling was to Barbara a suggestion or, rather, a command to fall. She was reacting to her mother's unconscious wish that she fall and not to the counter cathexis in the form of a concern about her falling.